Long-Term Care Pilot Underway

July 16, 2007
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West Michigan Care Connection is a new pilot program with the goal of providing information about long-term care choices for the disabled and elderly who are eligible for Medicaid, with the aim of keeping them in their homes.

“Single points of entry” are being used in at least 43 states to provide one stop for people seeking to make choices about supportive living services, such as the elderly, adults and children with physical disabilities, the developmentally disabled, and those with HIV/AIDS, for example.

In Michigan, the recommendation to create single points of entry for the disabled and elderly is one of nine in the 2005 report of the Michigan Medicaid Long-Term Care Task Force. With four pilot programs now under way, use of Michigan’s Care Connection services may eventually become mandatory for the disabled and the elderly to qualify for Medicaid, in addition to the financial qualification review performed by the state Department of Human Services.

Each pilot program is charged with developing a model that best suits the community. West Michigan Care Connection’s plan is to use a database of information and personal visits to outline choices for people in 12 West Michigan counties, said Chuck Logie, WMCC’s executive director. Consumers and their families may call a toll-free number to receive information about long-term care choices and may also arrange a personal visit from a counselor.

“We are trying to get away from the idea that the best solution is necessarily a facility,” Logie said. “Really, the big focus and what’s going to balance the Medicaid system is the idea that there are a lot of non-facility solutions, a lot of home help and home-based solutions.”

Amy Cobbler, supervisor of WMCC’s nine options counselors, said many inquiries can be handled over the telephone at the organization’s call center. “If someone is uncertain about what needs are, if they are looking for long-term care options but don’t know where to turn, that’s where an options counselor would become involved,” Cobbler said.

“They may just do a follow-up phone call to somebody. Some issues will be resolved with a face-to-face meeting. We will meet with people in their homes or any location they choose.”

Some say they are concerned that the Care Connection program will simply add another expensive layer of bureaucracy at a time when the state can least afford it because of budget troubles.

“We are very concerned that we’re utilizing new Medicaid dollars for a system that provides no direct level of health care services, when there is such a dire need for those that are providing health care services,” said Jon Reardon, board chairman for the Health Care Association of Michigan, a nursing home trade group. He owns the 128-bed Hoyt Nursing & Rehab Centre in Saginaw.

“If there was some viable basis that this was ultimately going to save money — who can argue with that? It’s just adding an additional expense to the system.”

Karen Messick, COO of Pilgrim Home, a Grand Rapids nursing home, is a member of the WMCC provider focus group. She said her concerns focus on the details: control over Medicaid placements, clinical expertise in the WMCC, and distinction between the needs of younger, disabled people and the elderly.

“I think the concept of single points of entry is wonderful,” Messick said. “How to operate that is a huge challenge.”

Christine Tilney, core service team leader for Disability Advocates of Kent County, gives a tempered endorsement to the program, noting that many details need to be ironed out during this experimental stage.

“Clearly, West Michigan Care Connection is in our camp in the independent living movement and philosophy,” Tilney said. “We’re very anxious to support anything that promotes community-based living. What we don’t need is another bureaucratic entity.”

Michigan’s four single points of entry pilot programs were urged to foster cooperation among agencies and to craft approaches uniquely suited to their areas. Locally, three organizations joined to sponsor WMCC: the Area Agency on Aging of Western Michigan, which uses federal, state and local dollars to arrange for services to help the elderly stay in their homes; HHS Health Options, a Grand Rapids nonprofit that contracts with the state, county and Heart of West Michigan United Way to provide case management for disabled adults and for the elderly; and Senior Resources, designated as an Area Agency on Aging for Muskegon, Logie said.

WMCC started out with a $3 million annual budget, with 90 percent federal funding and 10 percent from the state, Logie said. However, state budget cuts have slashed the program’s budget in half, he said.

The program is focused on those who rely on Medicaid to pay for their long-term care solutions, Logie said, but has been serving anyone who calls.

“So far, we’re not turning anybody down,” he said, adding that the pilot program receives 500 to 600 calls monthly. “It is geared toward publicly supported folks in our region.”

The region includes Kent, Muskegon, Ottawa, Montcalm, Allegan, Ionia, Mason, Lake, Osceola, Oceana, Newaygo and Mecosta counties.

“The idea is to enhance people’s choices, and make sure they have all the options and are really making choices based on their preferences,” Logie said. HQ

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